Bromley Mind - Mindcare

Updated 31 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out by one inspector on 21 November 2017 and was announced. We told the provider two days before our visit that we would be coming. We did this because we needed to be sure that the registered manager and staff would be in when we inspected.

Prior to the inspection we reviewed the information we held about the service and the provider which included statutory notifications the provider had sent the CQC. A notification is information about important events which the service is required to send us by law. The provider also completed a Provider Information Return (PIR). This is a form that asks the provider for some key information about the service, what the service does well and any improvements they plan to make. We also contacted the commissioning authority to request feedback on their views of the service. We used these sources of information to help inform our inspection planning.

There were approximately 83 people using the service at the time of our inspection. We spoke with six people by telephone and looked at the care plans and records for seven people using the service. We contacted five members of care staff and spoke with members of staff on site including the registered manager and service manager. As part of our inspection we looked at records used in relation to the management of the service such as policies and procedures and quality audits.

Updated 31 January 2018

This inspection took place on 21 November 2017. We gave the provider two days’ notice of the inspection as we needed to make sure the manager and staff would be available. At our last comprehensive inspection of the service on 10 and 11 October 2016 we made recommendations to the provider on the safe management and administration of medicines. This was because medicine records were not always completed appropriately by staff in line with best practice. There were no systems in place to seek and assess people’s consent and capacity and to act in accordance with the requirements of the Mental Capacity Act 2005 when required and risk management required improvements as risk assessments did not provide staff with detailed guidance on managing or reducing highlighted risks. At this inspection we found the provider had taken appropriate actions to address the areas requiring improvement and to ensure best practice.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service mainly to older adults. Not everyone using Bromley Mind - Mindcare receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. Bromley Mind - Mindcare is a carers’ respite and sitting service which provides support and some personal care to people living with dementia within their own homes. At the time of our inspection there were approximately 83 people using the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were safeguarding and whistle-blowing procedures in place and staff knew what actions to take to protect adults and children from harm. Any safeguarding concerns were reported appropriately to the local authority and CQC. There were robust recruitment checks in place before staff started work at the service. People told us that there were regular staff and there were enough of them to safely meet their needs. Risks to people were assessed, managed and reviewed regularly to ensure people’s needs were safely met. Where incidents and accidents occurred these were reviewed regularly to ensure that the risk of them re-occurring was reduced. Staff were knowledgeable about risks to people as care plans gave detailed guidance to them. Medicines were managed and administered safely and appropriately and audits conducted to ensure that medicines practice was safe. People were protected from the risk of infections and staff had received training in respect of infection control.

Assessments of people’s care and support needs were conducted to ensure that the care they received was suitable. Staff were competent and had received an appropriate induction before they started work and had regular training relevant to the needs of people that they supported. Staff also received regular supervision where any training needs or concerns could be discussed as well as an annual appraisal. People were supported to meet their nutritional needs, and staff were aware of any specific dietary requirements people may have. People were supported to access health and social care professionals when necessary. Staff were aware of the importance of seeking consent from people they supported and demonstrated good knowledge of the Mental Capacity Act 2005. There were arrangements in place to comply with the Mental Capacity Act 2005.

People told us staff were caring and respectful when they provided care. People had been consulted about their care and support needs and were given appropriate information about the service such as how to make a complaint and the providers statement of purpose. People were supported to communicate their needs and information was available in a format that met their needs. People told us they received personalised care that met their needs. Care plans were detailed and had information about people and their preferences. People knew about the provider’s complaints procedure and said they felt comfortable raising concerns if necessary. There had been no formal complaints since our last inspection.

There were effective quality assurance systems in place to evaluate and monitor the quality of the service provided to people. The provider took into account the views of people through satisfaction surveys and other communication methods and made improvements where necessary. Staff said they enjoyed working at the service and they received good support from the manager and office staff. There was an out of hours on call system in operation that ensured management support and advice was always available. The service worked closely with external organisations to meet people's needs and to improve the quality of the service they provided.